Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2018

Kahn, Katherine E.; Black, Carla L.; Ding, Helen; Williams, Walter W.; Lu, Peng–jun; Fiebelkorn, Amy Parker; Havers, Fiona; D’Angelo, Denise V.; Ball, Sarah; Fink, Rebecca V.; Devlin, Rebecca

doi:10.15585/mmwr.mm6738a3

Cited by 116 publications

(144 citation statements)

References 9 publications

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“…Over half of the pregnant women in our sample intended to receive all recommended maternal vaccines, aligning with recent national data. 9 Over two-thirds intended for their baby to receive all recommended infant vaccines on time, which was also consistent with recent national data. 3 However, a substantial proportion of pregnant woman did not intend to vaccinate themselves or their children according to the recommended immunization schedule.…”

Section: Discussionsupporting

confidence: 86%

“…8 Vaccine coverage for maternal vaccines is suboptimal, with only about half of pregnant women receiving influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccines in 2018. 9 Knowledge, attitudes, and beliefs of pregnant women regarding maternal vaccines are also suboptimal, although pregnant women's attitudes and beliefs toward infant vaccines have not been as well characterized. [10][11][12][13][14][15][16][17][18] Many parents primarily seek out vaccine information during and immediately after their first pregnancy.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing the vaccine knowledge, attitudes, beliefs, and intentions of pregnant women in Georgia and Colorado

Dudley

Limaye

Omer

et al. 2020

Human Vaccines & Immunotherapeutics

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Vaccine coverage for maternal vaccines is suboptimal; only about half of pregnant women received influenza and Tdap vaccines in 2018. We explored knowledge, attitudes, beliefs, intentions, and trust regarding maternal and infant vaccines among pregnant women. Between June 2017 and July 2018, we surveyed 2196 pregnant women recruited from geographically and socio-demographically diverse prenatal care practices in Georgia and Colorado (56% response rate). Fifty-six percent of pregnant women intended to receive both influenza and Tdap vaccines during pregnancy and 68% intended to vaccinate their baby with all recommended vaccines on time. Attitudinal constructs associated with intention to vaccinate include confidence in vaccine safety (ORs: 16-38) and efficacy (ORs: 4-19), perceived risk of vaccine-preventable diseases (ORs: 2-6), social norms (ORs: 4-10), and trust in sources of vaccine information. Women pregnant with their first child were less likely than women who had prior children to intend to vaccinate themselves and their children, more likely to be unsure about their intentions to receive both maternal and infant vaccines, and less likely to report feeling they had enough knowledge or information about vaccines and vaccine safety (p < .01). This demonstrates an opportunity for vaccine education to increase vaccine confidence and informed decision-making, especially among first-time pregnant women. ARTICLE HISTORY

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Characterizing the vaccine knowledge, attitudes, beliefs, and intentions of pregnant women in Georgia and Colorado

Dudley

Limaye

Omer

et al. 2020

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…13 While in the elderly both confounding-by-indication and healthy-vaccinee bias coexists and may strongly operate in opposite directions, in pregnant women confounding-by-indication could be weaker and the healthy-vaccinee bias much stronger. A CDC recent report 14 have provided new convincing evidence of this objective bias. CDC analyzed data from an Internet panel survey conducted during March 28-April 10, 2018.…”

Section: Evidence From Observational Studiesmentioning

confidence: 99%

Influenza vaccination for all pregnant women? So far the less biased evidence does not favour it

Donzelli¹

2019

Human Vaccines & Immunotherapeutics

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Pregnant women are a WHO priority group for influenza vaccination, but evidence from observational studies in pregnancy is subject, among others, to the healthy-vaccinee bias, overestimating the vaccine effectiveness and safety. An USA survey adds new evidence that documents this bias. Therefore, it is essential to assess vaccine effectiveness and safety with RCTs. Cochrane reviews identified one RCT with "low risk of bias", in a medium-income country, with NNV 55 for mothers. Its data show an excess of local adverse effects, and a tendency to harm for serious adverse events, with uncertain or very limited protection against influenza. A subsequent larger trial in a very-low-income African country found an excess of infant serious infections plus deaths in the influenza vaccine group. Also an available previous small trial and a subsequent large one in Asian low-income countries showed in tendency more deaths in the offspring vaccine groups. Before promoting seasonal influenza vaccinations during all pregnancies, more independent trials are needed, with appropriate designs and comparators. Meanwhile, vaccination in second-third trimester could be offered communicating the uncertainties and promoting informed choices, without neglecting to promote other protective behaviors.

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“…In addition, only about 50% of pregnant women receive influenza or tetanus, diphtheria, and acellular pertussis vaccine (Tdap) vaccinations, and only about 33% receive both. 4 On a positive note, strong evidence shows that increasing immunization rates reduces morbidity and mortality via both direct and indirect protection. Even though its effectiveness is less than perfect, influenza vaccine still directly protects adults who receive it, 5 although season-to-season variations make calculating deaths from influenza difficult.…”

Section: Vaccine-preventable Diseasementioning

confidence: 99%

Vaccination of Adults in General Medical Practice

Hunter

Fryhofer

Szilâgyi

2020

Mayo Clinic Proceedings

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In vaccinating adults, clinicians face 2 types of challenges: (1) staying current on recommendations for influenza, pneumococcal, hepatitis A and B, zoster, and other vaccines and (2) addressing systemic barriers to implementing practices that increase vaccination rates. Although adult immunization rates remain suboptimal, there has been much good news in adult vaccination recently. New high-dose and adjuvanted influenza vaccines help improve immune response and may reduce influenza complications in older adults. The new recombinant zoster vaccine offers significantly more efficacy against zoster outbreaks and postherpetic neuralgia than zoster vaccine live. Pertussis vaccine given during the third trimester of pregnancy may prevent between 50% and 90% of pertussis infections in infants. Shorter time for completion (1 vs 6 months) of new, adjuvanted hepatitis B vaccine may increase adherence. Clinicians can address systemic barriers to increasing vaccination rates in their clinics and health care systems by following the Centers for Disease Control and Prevention's Standards for Adult Immunization Practice. Clinicians can help increase vaccination rates by writing standing orders and by advocating for nurses or medical assistants to receive training and protected time for assessing and documenting vaccination histories and administration. Strong recommendations that presume acceptance of vaccination are effective with most patients. Communication techniques similar to motivational interviewing can help with vaccine-hesitant patients. Clinicians, as experts on providing preventive services, can educate community leaders about the benefits of immunization and can inform vaccine experts about challenges of implementing vaccination recommendations in clinical practice and strategies that can work to raise vaccination rates.

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Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2018

Cited by 116 publications

References 9 publications

Characterizing the vaccine knowledge, attitudes, beliefs, and intentions of pregnant women in Georgia and Colorado

Characterizing the vaccine knowledge, attitudes, beliefs, and intentions of pregnant women in Georgia and Colorado

Influenza vaccination for all pregnant women? So far the less biased evidence does not favour it

Vaccination of Adults in General Medical Practice

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